Zvakajairika kunzwa mutoro mukuru kana chiremba akakuudza, kana mumwe munhu waunoziva, kuti une dambudziko reitsvo , kunyanya chirwere chinonzi IgA Nephropathy (IgAN). Ichi chirwere chinokuvadza itsvo nekuda kwechikanganiso chidiki muimmune system yemuviri wedu. Saka nhasi tichataura nezvechirwere ichi nemushonga mutsva unonzi Vanrafia, zviri nyore.
Chii chinonzi IgA nephropathy (IgAN) chaizvo?
Zvichitaurwa zviri nyore, IgA nephropathy (IgAN) chirwere chinokonzerwa ne autoimmune . Dzimwe nguva chinonzi chirwere chaBerger , chinoitika kana masoja emuviri , kunyanya rudzi rweprotein inonzi Immunoglobulin A (IgA), akaungana muitsvo oita mabundu madiki.
Fungidzira kuti varindi vemuviri wedu vakarasika uye vakagara mukati meitsvo dzedu. Ma antibodies aya anokonzera kuzvimba muhurongwa hwekusefa husina kusimba hweitsvo, uye nekufamba kwenguva, itsvo dzinotanga kukuvara zvishoma nezvishoma (nephropathy). Kukuvara uku kunodzivirira itsvo kuti dzisasefe tsvina kubva mumuviri nemazvo.
Vanrafia mushonga mutsva wakatenderwa kurapa varwere vane IgAN vari panjodzi yekurwara zvakanyanya. Ndeweboka remishonga inonzi endothelin receptor antagonists. Mishonga iyi inoshanda nekuvharira mareceptors anotora mameseji anokonzera kuzvimba nekukuvadza itsvo. Zvakafanana nekumisa meseji inokuvadza kuti isasvike panzvimbo chaiyo.
IgAN inowanzo tarisirwa sei?
Chikwata cheKidney Disease Initiative Group (KDIGO) chiri kupa mazano enzira dzakanakisisa dzekurapa zvirwere zvakaita seIgAN. Heano mamwe emazano avo makuru.
Chinhu chinonyanya kukosha ndechekuti mishonga yese iyi inosarudzwa nachiremba anoongorora mamiriro ako. Saka , usambofa watanga kana kurega kutora chero mushonga usina kupiwa mazano nachiremba.
Heano nzira huru dzekurapa dziri kushandiswa parizvino uye zvinangwa zvadzo.
| Chinangwa chenzira yekurapa | Tsananguro nemienzaniso |
|---|---|
| Kudzora BP | Zvakakosha kuti BP isapfuure 130 mm Hg (muganho wepamusoro) muvarwere veIgAN. Mishonga yakasiyana-siyana inoshandiswa pachinangwa ichi. Mienzaniso: - Mishonga inodzivirira ACE (semuenzaniso Captopril, Lisinopril) - MaARB (semuenzaniso Losartan, Valsartan) - Zvinovharira calcium channel (semuenzaniso Amlodipine, Nifedipine) |
| Kuderera kweprotein muweti (Proteinuria) | Kana uine mapuroteni akawanda muweti yako (proteinuria), unogona kunyorerwa mushonga weACE inhibitor kana ARB, kunyangwe usina BP yakakwira. Dzimwe nguva, mishonga inonzi SGLT2 inhibitors (semuenzaniso, Dapagliflozin, Empagliflozin) inoshandiswawo. |
| Kuchinja kwemararamiro | Kuderedza munyu mukudya, kurovedza muviri, kurega kusvuta, uye kudzora huremu zvese zvakakosha pakudzora BP uye hutano hwese. |
| Kuderedza njodzi yechirwere chemwoyo | Pamwe chete nemararamiro ane hutano, zvinokurudzirwawo kuderedza njodzi yezvirwere zvemwoyo nekushandisa mishonga inoderedza cholesterol kana zvichidikanwa. |
Mushonga weVanrafia unotenderwa kuvarwere "vane njodzi huru" vane huwandu hwakawanda hweprotein muweti yavo (inopfuura 0.75 - 1 gram pazuva) kunyangwe vakatevera kurapwa kwataurwa pamusoro apa kwemwedzi mitatu.
Kubudirira kwemushonga weVanrafia kwakaedzwa sei?
Kuedzwa kwekiriniki yeALIGN kwakadzidza kushanda uye kuchengetedzeka kweVanrafia muvarwere vari panjodzi huru yekubatwa neIgAN yakanyanya.
- Ndivanaani vakapinda?:Varwere vanosvika 270. Hafu yavo vakapihwa mushonga weVanrafia, uye imwe hafu yakapihwa piritsi re placebo risina mushonga.
- Chii chakayerwa?: Mushure memavhiki makumi matatu nematanhatu ekurapwa, chiyero cheprotein-creatinine chemuweti chakayerwa kuti chionekwe kuti chakaderera zvakadii. Chiyero ichi chikakwira, kukuvara kweitsvo kunowedzera.
Zvakabuda zvakaratidza kuti chiyero cheprotein-to-creatinine muweti chakadzikira ne38% muvarwere vakapihwa Vanrafia, zvichienzaniswa ne3% chete muvakapihwa placebo. Izvi zvinoratidza kuti Vanrafia inoderedza zvakanyanya kuburitswa kweprotein muitsvo.
Chii chatinoziva nezvemigumisiro yenguva refu yemushonga uyu?
Vanrafia mushonga unotenderwa pasi pemaitiro anonzi "accelerated approval." Kureva kuti, mushonga unowanikwa kuvarwere nekukurumidza zvichibva pane zvakawanikwa pakutanga kweongororo yezvirwere zvakakomba pamwe nedzimwe nzira shoma dzekurapa.
Zvisinei, mushure mekubvumidzwa uku, kambani yemishonga inofanira kuramba ichitsvaga kuti ione kana mushonga uyu uchideredza kukuvara kweitsvo kwenguva refu. Kuedzwa kweALIGN kuchiri kuenderera mberi. Mhedzisiro yayo yenguva refu ndiyo ichaona kana mushonga uyu ucharamba uri pamusika kana kwete.
Panogona kuva nematambudziko nemimwe mishonga here? (Kudyidzana Kwemishonga)
Ehe, Vanrafia inogona kupindirana nemimwe mishonga. Izvi zvinogona kuderedza kushanda kweVanrafia kana kuwedzera migumisiro yakaipa.
- Mishonga inowedzera njodzi yemigumisiro: Migumisiro yeVanrafia inogona kuwedzera kana ikatorwa nemishonga iri muboka rinonzi `(OATP)1B1/1B3 inhibitors`.
- Mishonga inoderedza kushanda: Kushanda kweVanrafia kunogona kuderedzwa kana ikatorwa nemishonga iri muchikamu cheCYP3A inducers.
Saka , zvakakosha kuudza chiremba wako nezvemishonga yese yauri kutora (kusanganisira mavhitamini nemishonga yechivanhu). Zvadaro anogona kusarudza mushonga wakakodzera iwe.
Zvaunofanira kuziva nezvekushandisa Vanrafia panguva yekuzvitakura
Iyi inyaya inokosha zvikuru. Kana Vanrafia ikatorwa panguva yekuzvitakura, inogona kukonzera matambudziko makuru ekuzvarwa kwemwana.
- Kana uri mukadzi ane mukana wekubereka vana, unofanira kutora bvunzo yekuzvitakura kuti usimbise kuti hauna pamuviri usati watanga kushandisa Vanrafia.
- Kana uine pamuviri kana kuti uchironga kubata pamuviri, haufanirwe kutora mushonga uyu zvachose.
- Nzira inoshanda zvikuru yekudzivirira pamuviri panguva yekurapwa uye kwemavhiki maviri mushure mekumira kurapwaZvinosungirwa kuishandisa. Taura nachiremba wako kana chiremba wevakadzi nezvenzira yekudzivirira pamuviri yakakunakira.
- Kana nguva yako yekutevera yanonoka panguva yekurapwa kana kuti uchifungidzira kuti une pamuviri, zivisa chiremba wako nekukasika.
Zvinhu zvekuziva kana uchitora mushonga uyu
Vanrafia mushonga wemhando yepamusoro. Izvi zvinoreva kuti imhando yemushonga unodhura, unoshandiswa pazvirwere zvakaoma, uye hauwanikwe pamishonga yese.
Maitiro ekuwana mushonga uyu anogona kusiyana nekuwana mushonga wenguva dzose. Chiremba wako achakuzivisa nezvenzvimbo dzakatarwa (dzakadai sema pharmacy ezvipatara) kwaunogona kuwana mushonga uyu uye nzira dzekutevedzera. Ungangodawo kuwana mvumo yekutanga kubva kumakambani einishuwarenzi. Chiremba wako achakutungamira mumatanho ese aya.
Mharidzo Yekuenda Nayo Kumba
- IgA nephropathy (IgAN) chirwere chinokonzeresa kuti itsvo dzikuvadzwe nekushanda kwemasoja edu ekudzivirira chirwere.
- Vanrafia mushonga mutsva unobatsira kuderedza kubuda kwemapuroteni muweti yevarwere vane njodzi huru yekurwara zvakanyanya.
- Zvakakosha kudzora BP, kuchengetedza mararamiro ane hutano, uye kunwa mimwe mishonga yakanyorerwa nachiremba wako sezvakarayirwa.
- Kana uri kutora Vanrafia, zvakakosha kuti uzivise chiremba wako nezvemimwe mishonga yese yauri kutora.
- Mushonga uyu unokuvadza zvikuru pamuviri. Kudzivirira pamuviri kunoshanda kunofanira kushandiswa panguva yekurapwa uye kwemavhiki maviri mushure mekumira.
- Gara uchitaura nachiremba wako nezvechirwere chako uye marapirwo aunoita, uye tevera mazano ake.
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